Carrying out the settlement of a class-action lawsuit that drastically changed how Utah cares for the mentally disabled has cost the state at least $1.7 million.
In a review of the financial impact of the so-called Lisa P case released Wednesday, the state auditor general reports that the bulk of the money was spent implementing a special evaluation process for each resident in the Utah State Developmental Center in American Fork.
The cost of legal services incurred while the case was in court are not included in the $1.7 million.
Rep. Margaret Dayton, R-Orem, said she called for the audit because she was "very concerned" about the amount of money the state was paying to settle a lawsuit that she believes was being driven more by a national movement to close institutions than what was necessarily best for the residents.
"I have very strong feelings there is need for that kind of facility," Dayton said. "They talk about the mentally disabled needing the least restrictive care, but for those who need 24-hour care for their own safety, this setting is the least restrictive."
The state has no plans of shutting down the center.
The suit was filed on behalf of the residents in December 1989 by the Disability Law Center and the ARC of Utah. It accused the state of overusing restraints and medication to control patients as well as creating a generally unsafe environment at the center.
As part of a settlement reached in October 1993, the state was required to appoint teams of experts to evaluate each resident. Evaluators decided whether the center or a community program would provide the "least restrictive and most enabling environment" for each individual. The suit was dismissed this past February after the plaintiffs agreed that the state had satisfactorily complied with the terms of the settlement agreement.
There were 371 residents at the center when evaluations were started. Of the 309 individuals who were ultimately reviewed, 206 stayed at the center and 103 moved or are in the process of moving into the community. The teams recommended that 143 residents be moved to the community, but 40 did not move, most often because families and guardians believed the center was the best setting for them.
The population at the center has declined from 666 residents in 1986 to 212 now.
Several family members and guardians told the Deseret News that they are worried that despite the settlement, the Disability Law Center will keep insisting that some residents be moved out. Law Center representatives have said they will not do so.
The audit, however, states that conflicts continue over how to weigh parents' wishes with professional judgments about what constitutes the most appropriate placement.
Not included in the total cost of the settlement is the $1.2 million budget increase approved by the Legislature to implement the Lisa P settlement. The increase began in July 1998 and covers the additional service costs for both those who moved into the community and for those who remained at the center.
The audit also reports that four years of litigation leading to the settlement cost the state at least $250,000 in salaries, benefits and overhead for the Attorney General's Office.
Law Center costs were not included because state funds were not used to pay for its services. The center is part of a nationwide network of a protection and advocacy system mandated by Congress to provide legal representation and advocacy on behalf of all people with disabilities. The Law Center estimates its attorney and staff costs were $225,000.
The potential savings resulting from the end of litigation due to the settlement were also not taken into account.
The auditors don't expect further costs resulting from the lawsuit. It was dismissed "with prejudice," which means it is over and cannot be brought again. Each center resident will continue to have a formal annual review required by the Social Security Act.
Auditor General Wayne L. Welsh said the costs are actually estimates because no one kept track of settlement costs as they were incurred, noting if the state wants a better record kept in the future, legislation could be enacted to require it.
Utah law now requires terms of settlement agreements be approved before the state enters into financial obligations exceeding $100,000. The Lisa P settlement preceded the reporting requirement.
E-mail: jthalman@desnews.com